Help - Coverage Details
The Coverage Details page displays more information about a specific benefit plan. The glossary below explains many of the terms used.
Accounts and Insurance Glossary
- Coinsurance:
- The percentage of cost you pay for a covered healthcare service.
- Copay:
- A fixed amount you pay for a covered healthcare service.
- Deductible:
- The amount you (or your family) must pay before your health plan starts to cover some of the cost.
- Authorization Required:
- Indicates whether you need authorization for this benefit. Your health plan may cover less of the cost if you don’t have authorization, and you might be responsible for paying more.
- Limit:
- Some benefits are paid differently after you’ve used up a certain number of visits, procedures, or dollars. The limit indicates when your payment will change.
- Remaining:
- How much is left before you hit a limit
- Level:
- Level refers to which payment level you are at. If this benefit has a limit, you might change payment levels once you reach the limit.
- Maximum Out Of Pocket (MOOP) Expenses:
- The most you (or your family) have to pay for certain covered services within a plan year.
- Network:
- Some benefits are paid differently if you are In or Out of network. ‘In’ is what you would pay at an In network doctor. ‘Out’ is what you would pay at an Out of network doctor. ‘N/A’ or blank means that it does not matter.